In The News

NQF Leads a National Discussion about Opioid Stewardship

March 29, 2018

Nearly 600 members of the public joined NQF’s National Quality Partners™ (NQP™) Opioid Stewardship Action Team for a March 29 national discussion about how healthcare organizations, clinicians, pharmacists, and patients can support safe and effective pain management strategies, including appropriate prescribing of opioids.

At the heart of the discussion was the recently launched NQP Playbook™: Opioid Stewardship, which offers practical strategies, identifies barriers and solutions, and provides tools and resources for implementing or strengthening existing opioid stewardship programs across the country. Here are some of the discussion highlights:

“We’re quite excited about the NQP Playbook and the applicability to many different organizations at different stages of development in their own work on opioid stewardship,” said Paul Conlon, PharmD, JD, senior vice president, chief quality and patient safety, Trinity Health, and co-chair of the NQP Opioid Stewardship Action Team.

“Nine surgeries, nine times I was prescribed opioids for pain medicine, and nine times I wasn’t really given an option of other pain management suggestions,” said Joan Maxwell, patient partner and NQP Opioid Stewardship Action Team member representing Patient and Family Centered Care Partners, Inc.

“We got here as a nation in an attempt to solve a problem, which was our failure…to effectively manage pain,” said Alice Bell, PT, DPT, senior payment specialist, American Physical Therapy Association and NQP Opioid Stewardship Action Team member. She later added, “There is a role for opioids in pain management. This is not an all-or-nothing phenomenon.”

Join NQF’s national discussion to improve pain management for patients! Download your copy of the NQP Playbook from the NQF Store. Register today for NQF’s May 1 fully-accredited workshop, "Driving Patient Safety and Quality through Opioid Stewardship" to gain the frontline resources and strategies you need to improve opioid stewardship, pain management practices, and patient outcomes at your organization.

On Thursday, HHS Secretary Alex Azar announced the appointment of two individuals to lead initiatives in areas he has identified as priorities for the Department. Secretary Azar has previously identified four initiatives for his transformation agenda: combating the opioid crisis; bringing down the high cost of prescription drugs; addressing the cost and availability of health insurance; and transforming our healthcare system to a value-based system. The individuals who will be taking key roles on opioids and prescription drug pricing are:

Daniel M. Best will be Senior Advisor to the Secretary for Drug Pricing Reform. Mr. Best will lead the initiative to lower the high price of prescription drugs.

Brett Giroir, M.D., will, in addition to his duties as Assistant Secretary for Health, serve as Senior Advisor to the Secretary for Mental Health and Opioid Policy. Dr. Giroir will be responsible for coordinating HHS’s efforts across the Administration to fight America’s opioid crisis.

“Under President Trump, HHS has an historic opportunity to confront a number of America’s pressing health challenges, including the high price of prescription drugs and our country’s opioid crisis,” said Secretary Azar. “These leaders will play a unique role at HHS in driving coordination and results on these vital issues.”

“Daniel Best recognizes what President Trump and I, and every American know: prescription drug prices are too high. He has the deep experience necessary to design and enact reforms to lower the price of medicines that help Americans live healthier and longer lives.

“Brett Giroir, our Assistant Secretary for Health, will use his exceptional talents to tackle our country’s crisis of opioid addiction and overdose. His experience coordinating major projects within the federal government will bring new focus to our efforts on this issue.

“These two leaders will be invaluable to HHS and will advance the good work already being done at the Department serve the American people.”

Leaders for healthcare payment reform and value-based transformation of the healthcare system, will be announced in the coming weeks.

Biographical Background

A highly accomplished, top-performing healthcare industry executive, Daniel Best is an expert on both the pharmaceutical landscape and the largest single payer for prescription drugs, the Medicare Part D program. Best recently served as the Corporate Vice President of Industry Relations for CVSHealth’s Medicare Part D business. This included the company’s prescription drug plans, Medicare Part D plans, and other clients, which together provide prescription drug coverage for millions of Americans. Prior to working at CVS, Best spent 12 years at Pfizer Pharmaceuticals.

Dr. Brett Giroir is HHS’s Assistant Secretary for Health, a role he will continue. He is a four-star admiral in the U.S. Public Health Service Commissioned Corps. Dr. Giroir is the former Director of the Defense Science Office at the Defense Advanced Research Projects Agency (DARPA), and has spent his career leading major projects for academic institutions and the U.S. Departments of Defense, Health and Human Services, and Veterans Affairs. He has been recognized for his novel approach to using biomedical advancements that have accelerated the development and manufacturing of vaccines and other treatments for pandemic influenza and emerging infectious diseases.

Abstract

Problem/Condition: Doctor-diagnosed arthritis is a common chronic condition affecting an estimated 23% (54 million) of adults in the United States, greatly influencing quality of life and costing approximately $300 billion annually. The geographic variations in arthritis prevalence, health-related characteristics, and management among states and territories are unknown. Therefore, public health professionals need to understand arthritis in their areas to target dissemination of evidence-based interventions that reduce arthritis morbidity.

Reporting Period: 2015.

Description of System: The Behavioral Risk Factor Surveillance System is an annual, random-digit–dialed landline and cellular telephone survey of noninstitutionalized adults aged ?18 years residing in the United States. Self-reported data are collected from the 50 states, the District of Columbia, Guam, and Puerto Rico. Unadjusted and age-standardized prevalences of arthritis, arthritis health-related characteristics, and arthritis management were calculated. County-level estimates were calculated using a validated statistical modeling method.

Results: In 2015, in the 50 states and the District of Columbia, median age-standardized prevalence of arthritis was 23.0% (range: 17.2%–33.6%). Modeled prevalence of arthritis varied considerably by county (range: 11.2%–42.7%). In 13 states that administered the arthritis management module, among adults with arthritis, the age-standardized median percentage of participation in a self-management education course was 14.5% (range: 9.1%–19.0%), being told by a health care provider to engage in physical activity or exercise was 58.5% (range: 52.3%–61.9%), and being told to lose weight to manage arthritis symptoms (if overweight or obese) was 44.5% (range: 35.1%–53.2%). Respondents with arthritis who lived in the quartile of states with the highest prevalences of arthritis had the highest percentages of negative health-related characteristics (i.e., arthritis-attributable activity limitations, arthritis-attributable severe joint pain, and arthritis-attributable social participation restriction; ?14 physically unhealthy days during the past 30 days; ?14 mentally unhealthy days during the past 30 days; obesity; and leisure-time physical inactivity) and the lowest percentage of leisure-time walking.

Interpretation: The prevalence, health-related characteristics, and management of arthritis varied substantially across states. The modeled prevalence of arthritis varied considerably by county.

Public Health Action: The findings highlight notable geographic variability in prevalence, health-related characteristics, and management of arthritis. Targeted use of evidence-based interventions that focus on physical activity and self-management education can reduce pain and improve function and quality of life for adults with arthritis and thus might reduce these geographic disparities.

Dear Presley Pride,You recently read about the All of Us Research Program, an ambitious initiative by the National Institutes of Health (NIH) that is exploring individual biological, environmental, and behavioral factors affecting health and disease. This email highlights why it is important for you and your practice to be a part of this historic research program.

The All of Us Research Program, a key component of the federal government's Precision Medicine Initiative, has begun enrolling a diverse population of participants and is rapidly building a large network of partner organizations.

Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a person's health, disease, or condition, and to better predict which treatments and prevention strategies will be most effective. Data and information from participants in All of Us are expected to help accelerate health research and medical breakthroughs, and thus facilitate individualized disease prevention, treatment, and care for everyone.

Advancing health care in a variety of ways

The All of Us Research Program is expected to contribute to advances in health care in a variety of ways, such as identification of the causes of individual variation in response to commonly used therapeutics, and discovery of biological markers that signal increased or decreased risk of developing common diseases.

The program is currently collecting a limited set of standardized patient data from different sources. However, the types of data collected by All of Us will grow and evolve over time.

Sources of data currently being collected by All of Us

Participant questionnaires

Electronic health records

Physical measurements

Biosamples (blood and urine samples)

Mobile/wearable technologies

Geospatial/environmental data

'Arming' patients with wearable devices

One particularly exciting aspect of All of Us is the generation of data from wearable devices that will make it possible to explore the relationship between everyday activities and health outcomes.

Scripps Translational Science Institute (STSI), a part of the Scripps Research Institute in San Diego, is responsible for designing and implementing strategies to keep diverse populations of participants engaged over the long term. Commenting on the importance of gathering individual data from wearable devices, Steven Steinhubl, MD, Director of Digital Medicine at STSI, said that the program will provide "access to comprehensive activity, heart rate, and sleep data that may help us better understand the relationship between lifestyle behaviors and health outcomes and what that means for patients on an individualized basis."

AHRQ’s Academy for Integrating Behavioral Health and Primary Care now offers an updated online list of resources and tools to promote integrating behavioral health with primary care. Medication-assisted treatment (MAT) for opioid use disorder (OUD) tools and resources are available to help patients, providers and community organizations battle the opioid epidemic. The Opioid & Substance Use Resources page includes information and tools from Federal sources, health professional societies, academic institutions and researchers. Another feature, the Literature Collection, provides access to the growing inventory evidence on the integration of behavioral health and primary care. The online Academy Community allows individuals and practices working to implement MAT to collaborate and share insights with peers.

NIH program to accelerate therapies for arthritis, lupus releases first datasets

Collaborative effort provides important clues about potential research targets.

Coordinated Approaches to Strengthen State and Local Public Health Actions to Prevent Obesity, Diabetes, and Heart Disease and Stroke

Chronic diseases, including heart disease, stroke, cancer, diabetes, and obesity, are the leading causes of death in the United States and account for most of the nation’s health care costs (1). Heart disease is the leading cause of death among men and women in the United States, accounting for 1 of every 4 deaths (1). Approximately 140,000 Americans die each year from stroke, and it is a leading cause of long-term disability (2,3). It is estimated that more than 9% of the US population has diabetes, which is the leading cause of kidney failure, lower-limb amputations other than those caused by injury, and new cases of blindness among adults (4). Additionally, more than one-third of US adults have obesity, which is associated with several chronic conditions (5,6).

Dr. David Meyers, M.D., AHRQ’s chief medical officer, recognizes the importance of February as Heart Health Month while highlighting important contributions made by AHRQ’s EvidenceNow initiative. AHRQ is working with more than 1,500 primary small- and medium-size care practices to help improve the delivery of services proven to prevent heart attacks and strokes. These include the “ABCS” of heart health – Aspirin use by high-risk individuals,Blood pressure control, Cholesterol management, and Smoking cessation. Dr. Meyers’ blog post describes examples of project successes, including expanded use of medications to prevent heart disease, more effective use of blood pressure measurement among patients at risk for heart attack or stroke, and increased use of smoking cessation counseling. AHRQ’s contributions to heart health are in alignment with the Million Hearts® initiative, a national effort to control risk factors for heart disease, the nation’s number one killer.

HHS Secretary Azar Statement on President Trump’s FY 2019 Budget

Health and Human Services Secretary Alex Azar issued the following statement today on President Trump’s Fiscal Year 2019 Budget:

“The President’s budget makes investments and reforms that are vital to making our health and human services programs work for Americans and to sustaining them for future generations. In particular, it supports our four priorities here at HHS: addressing the opioid crisis, bringing down the high price of prescription drugs, increasing the affordability and accessibility of health insurance, and improving Medicare in ways that push our health system toward paying for value rather than volume.

“This budget supports the hard work the men and women of HHS are already doing toward these goals. In particular, the budget’s efforts to reduce the high cost of prescription drugs, especially for America’s seniors, are a reflection of President Trump’s deep commitment to addressing this important issue.”

National Institutes of Health scientists developing a rapid, practical test for the early diagnosis of prion diseases have modified the assay to offer the possibility of improving early diagnosis of Parkinson’s disease and dementia with Lewy bodies. The group, led by NIH’s National Institute of Allergy and Infectious Diseases (NIAID), tested 60 cerebral spinal fluid samples, including 12 from people with Parkinson’s disease, 17 from people with dementia with Lewy bodies, and 31 controls, including 16 of whom had Alzheimer’s disease. The test correctly excluded all the 31 controls and diagnosed both Parkinson’s disease and dementia with Lewy bodies with 93 percent accuracy.

About Multiple Chronic Conditions

The Multiple Chronic Conditions website provides dynamic updates on all federal initiatives targeting the care and management of patients with multiple chronic conditions.

MCC Resource Center is identified by the US Department of Health and Human Services as a resource for health care professionals to remain current and informed on the clinical management of chronic conditions.Read more